Affiliations: Victor Horsley Department of Neurosurgery, The National Hospital for Neurology & Neurosurgery, London, UK
Correspondence:
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Address for correspondence: Ramesh Chelvarajah, MRCSEd, Victor Horsley Department of Neurosurgery, The National Hospital for Neurology & Neurosurgery, Queen Square, London WC1N 3BG, UK. E-mail: ramesh.chelvarajah@talktalk.net
Abstract: Introduction:Upright posture confers numerous medical and social benefits to a spinal cord injured (SCI) patient. Doing so is limited by symptoms of orthostatic hypotension. This is a common secondary impairment among tetraplegic sufferers. Objective:Establish the proportion of SCI patients who are restricted from using standing apparatus, such as standing frames and standing wheelchairs, because of inducing symptomatic orthostatic hypotension or the fear of developing these disabling symptoms. Study Design:Survey conducted by Internet-accessible electronic questionnaire. Questionnaire validated for reliability and accuracy. Results:293 respondents. Mean age 44.6; 76% male. Median time from injury: 7 years. 38% suffered with orthostatic hypotension; majority were complete injuries and all (except one – T12) were T5 or above level. 52% replied that they were using standing wheelchairs or frames. Of these, 59 (20% of total) stated that orthostatic hypotension symptoms were limiting the use of their upright apparatus. Of those who did not use standing wheelchairs or frames, 16 (5.5% of total) reported that this was because of the fear of worsening their orthostatic hypotension. Conclusion:Orthostatic hypotension restricts standing apparatus use in a large proportion (a total of 25.5% of respondents in this survey) of SCI patients.
